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1376714105
SUSAN J ROETH
FORT CARSON, CO
NPI
1376714105
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CO 975)
Enumeration Date
2008-03-19
Last Update Date
2011-04-05
Business Address
Ms. SUSAN J ROETH LCSW
1853 OCONNELL BLVD BLDG 1056, ROOM 9
FORT CARSON, CO 80913-4055
Phone number: 719-526-6823
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Mailing Address
Ms. SUSAN J ROETH LCSW
652 N 30TH ST
COLORADO SPRINGS, CO 80904-2104
Phone number: 719-634-4294
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